Volunteering - What does it mean to be a nurse beyond the walls of the hospital?

Dr. Reezena H. Malaska, DNP, MSN, RN, CCRN
Health, Healthcare, Information May 29, 2019 0

As nurses we go to work and do our best to take care of our patients, provide treatment and care hoping that the advice will be continued upon discharge home. But what else can we do as nurses, healthcare providers to give back to our patients and their communities? Many nurses may have thought about volunteer work but do not know what it entails and how to get started.  This month’s blog is about volunteering in the community and it’s far reaching effects. Nurses have the influence and power to change lives. How can we continue to make a difference in the health and well-being of our community members beyond the walls of the hospital?

Screening events are commonly offered by the public health department, community health clinics, churches, and healthcare facilities as part of population health promotion, disease preventive efforts.  Screening events include blood pressure checks, diabetes, stroke, heart disease education, and community based flu shot clinic. The goal is to educate the public, influence positive behaviors in self-care, self-management of one’s health and reduce mortality by early identification, and diagnosis of diseases with early treatment/intervention.

As professional nurses interacting with the public on a daily basis we must be cognizant of our public position, level of responsibility, and accountability (Oyetunde & Brown, 2012). Along with health screenings and flu clinics comes the professional accountability and responsibility of the volunteers and health professionals carrying out the screening. Our individual roles and responsibilities were different, guided by the public health department volunteer specific policies and procedures.

My first exposure to the differences in professional accountability was when I participated in a screening/flu shot clinic held by the Virginia public health department (Loudoun County Medical Reserve Core) several years ago. I was clueless when I first joined the team. I only knew how to practice as a nurse in a traditional acute care hospital setting with supportive departments, and medical teams at hand. We were encouraged to adhere to the health department procedures and not deviate. At first I was puzzled, but a thorough explanation of the liability aspect for RN volunteers made sense.

The flu shot event was held in a high school gymnasium for a few hundred high schoolers. Students were screened using a script to determine eligibility, consent was then completed and students were directed to form a line for the flu shot. Once the vaccine was received, students were instructed to wait on the bleachers for a set period of time to monitor for adverse reaction. This part of the vaccination process was challenging because each student had a different time (time of administration plus waiting time) on their paperwork, some were non-compliant with the process, wanting to depart before the allotted wait time was completed. Fortunately, there were no adverse reactions. The director of volunteers typically led a debriefing meeting with discussions focused on what went wrong, what went right, what could be improved, and solicited suggestions at the end of every event.

As an MRC volunteer I was required to complete FEMA courses in disaster preparedness. For disaster and emergency preparedness I attended courses in “Radiation Basics” (4 hour class) and “Rapid Psychological First Aid” (8 hour class) taught by a world renowned, experienced (international disasters) professor from Johns Hopkins University, Public Health Preparedness Program department. 

In July 2011, I volunteered 16 hours with the Medic teams staffed the BLS and ACLS tents at the 150th re-enactment anniversary of the Battle of Bull Run, Manassas, Virginia. In January 2013, I was even more fortunate to be selected and deployed to Washington, D.C. as part of the basic life support and roving first aid team, staffed the BLS tents on the DC Mall to support the National Park Service, US Public Service (USPHS) and Disaster Medical Assistance Teams (DMATS) at the 57th Presidential Inauguration. I was the first (at the time) Virginia MRC Nurse Volunteer to be deployed for a federal support mission. Later, in spring 2013, I was lucky to be a part of the Dulles airport emergency disaster triannual exercise (7 hours) as moulage and actor, an eye-opening but enjoyable experience.

The importance of working together as a cohesive team with clear communication is key in the field where things can change in an instant as we work with limited medical resources and equipment on hand in extreme weather conditions. For example, January 2013 was one of the coldest winters in the DC area, a couple of heaters in the medic tent malfunctioned; therefore the heaters were reassigned from staff/volunteer areas to the patient care areas. We worked as best as possible with hand and feet warmers, bundled in layers taking turns to get warmed in the patient care areas. The medic tents reminded me of the popular, much-loved TV series MASH. 

At first it was daunting but I met many wonderful professionals, federal staff and volunteers from across the country.  Learning about their jobs, lives, and culture was enriching and exciting (FBI, CIA, fire-fighter, Medics). For a brief 12 hours we were a team from different federal, state, and local agencies working together in harmony for the same purpose. My volunteering started with flu shot clinics and propelled me to participating in once-in-a-lifetime opportunities once I demonstrated a willingness to learn and being available to do whatever was needed. It was similar to having a second job and one that I loved doing.

It was amazing to witness first-hand, the complexities and logistics, time it took planning, the preparation, and coordinating, being prepared for the mass public in attendance. Every event, the size of the event was different in how it was planned, executed and the agencies involved. We had some interesting health situations at the Presidential inauguration. This experience provided significant new knowledge and great insights into how the public health department functions, the financial constraints (federal funds), and the importance of volunteers as part of the structure of the Health Department’s Disaster plan. I have great respect for public health nurses and public health departments. I encourage my readers to consider volunteering locally and with medical missions. Anyone from any profession can be a volunteer. Bear in mind the commitment required in terms of hours for didactic training (late evenings, weekends), events, and being available (ASAP) in an actual disaster.

            How did I get started? I was restless at my critical care job, with nothing more to learn beyond my involvement with unit education and hospital committees. I wanted something new and different from hospital nursing that was stimulating, and challenging. Someone suggested volunteering with the local health department.  I did my homework and the rest as they say is history!

References

Oyetunde, M. O., Brown, V. B. (2012). Professional accountability: implications for primary

healthcare nursing practice. Jonas Healthc Law Ethics Requl. Oct-Dec; 14(4): 109-14. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23169184

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